I'm seconding Heather on this one.  The only problem as far as I can
tell is that the baby has failed to comply with the institution's
requirement to gain 28 grams in 24 hours.  In our institution the baby
would be in compliance because we are happy with 'about 15 to 20
grams' in those first days.  Especially if the 'required' weight gain
is the same for all babies, so that the 28 grams might be as little as
one half of one percent of the birthweight, or as much as one percent,
it seems unnecessary to supplement when the baby is gaining already.
Besides, since three days elapsed between two weighings, we don't know
whether the baby actually continued to lose weight for another 24
hours and then gained 31.5 grams in each of the two subsequent days.
Unless the baby will not be seen again for more than a week, I'd be
most comfortable not supplementing, and waiting for things to pick up,
assuming baby is able to feed effectively and mother knows which signs
in baby should be reported promptly to whoever is following them.

If you are in doubt about mother's ability to recognize danger signs
of underfeeding or they will be far from help, you could possibly
argue for supplementing, but since things seem to be going in the
right direction now, there is a greater risk of undermining BF by
supplementing, than of the baby starving if no supplement is given.

Rachel Myr
Kristiansand, Norway

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